Spatiotemporal evaluation of the Schistosomiasis control program indicators in an endemic area in Northeastern of Brazil: an historical overview of 46 years (1977 to 2023)

In this study we aimed to assess the spatiotemporal evaluation of the Schistosomiasis Control Program (PCE), from its implementation in 1977 to 2023 - an overview of 46 years. In this sense, we used data registered by the PCE in Alagoas and conducted an ecological, population-based study using spatial and temporal trend analysis techniques. Here, it was demonstrated that in the first year of the program, only 7.8% of the actual endemic area was attended by PCE, reaching 80% in 2023. During the analyzed period, the attended population temporal trend analysis showed a stable time trend between 1997 and 2006 (APC = 1.2; p -value 0,352), and a decreasing time trend between 2007 and 2023 (APC=-1.9; p-value 0,352). The number of municipalities with a positivity rate above 15% decreased from 66.1% (1977–1996) to 24.6% (1997–2007) and 3.75% in the last period analyzed (2008–2023), while the municipalities with a positivity rate below 5% increased from 8.3% to 61.4% at the same time. Although there are advances in combating and controlling Schistosomiasis in Alagoas, it continues to be a relevant public health issue. In addition, it is necessary to improve the PCE actions to cover the entire endemic area and include other environmental indicators in Schistosomiasis surveillance, such as monitoring water collections for malacological surveillance. Also, it is essential to raise awareness about strategic actions among public health managers to provide basic sanitation conditions in the endemic area.